This Mentored Patient-Oriented Research Career Development Award will provide training in intervention research testing psychotherapeutic treatments for depression among patients with histories of childhood sexual abuse and other lifetime traumas. Depression and childhood sexual abuse are prevalent and exact enormous psychological and economic costs for women's mental health and physical health. Childhood sexual abuse amplifies risk for major depression in women; the affective illness that ensues often is more severe, chronic, and complex, and hence more difficult to treat. Individual psychotherapies with proven efficacy in other treatment contexts have not been systematically investigated among depressed women with abuse histories in community- based settings. The educational plan provides explicit instruction, training, and supervision to prepare the candidate as an independent investigator of psychotherapeutic treatments for depressed patients with histories of childhood sexual abuse and other lifetime traumas. Mentored career development and research activities are designed to develop expertise in (a) the assessment, moderators, and outcomes of depression; and (b) clinical interventions research design and methods. The research plan lays the foundations for a program of systematic research into treatments for this high-risk subset of women by comparing interpersonal psychotherapy (IPT), an established treatment for depression, to usual care provided in a community mental health center. The study will use a 2 (treatment) X4 (pretest, 8-week, post test, 3-month follow-up) repeated measures design. Seventy women with major depression (DSM-IV) will be randomly assigned to IPT or usual care. IPT is hypothesized to lead to greater improvements in depressive symptoms, and psychological and social functioning. Key variables that moderate good and poor outcomes will be identified. The acceptability of IPT will also be examined. Results will guide the next state of research, which is to refine treatment strategies to improve health outcomes in an often-underserved and understudied patient population from diverse socioeconomic backgrounds within community-based settings.